State health plan slowly beginning to kick into gear

Slowly but surely, the process of providing affordable health insurance for more than 1.5 million North Carolinians is moving along.

The N.C. Department of Insurance has approved 67 insurance plans to be offered in the state by three different carriers under the Affordable Care Act. The plans now go to the U.S. Department of Health and Human Services for review and, we hope, approval.

Enrollment begins Oct. 1 and the Health Insurance Marketplace, commonly referred to as an insurance exchange, goes into operation Jan. 1. The federal government will operate North Carolina's exchange because the state has opted out.

"When you use the Health Insurance Marketplace," HHS explains on its website, "you'll fill out an application and find out if you can get lower costs on your monthly premiums for private insurance plans. You'll find out if you qualify for lower out-of-pocket costs.

"The marketplace will also tell you if you qualify for free or low-cost coverage available through Medicaid or the Children's Health Insurance Program (CHIP)."

Despite the 40th vote last week to repeal ACA in the House of Representatives,within six months, millions of people will learn how much better off they are under this landmark legislation. Once that happens, repeal will be inconceivable.

Many of the details, including rates, are not yet available. "If the feds cut the rates or make other changes, you would not get the true rate if you released the information now," said Adam Linker, a policy analyst at the N.C. Justice Center.

"Because only a few providers are offering plans, I wouldn't want them to see each other's rates, conclude they're not competitive, and pull out of the state."

Blue Cross, which has submitted 26 plans, is the only one of the three planning to offer subsidized coverage in all 100 counties.

"There are differences according to county as they differ in terms of access to providers and other health services," said Blue Cross spokesman Lew Borman.

Options will include a catastrophic plan and four coverage levels.

Catastrophic plans, designed for people under age 30 and those with very low income, have large deductibles and cover just three primary care visits a year but provide a cushion against ruinous medical bills.

Blue Cross has told its customers that subsidized policies will cost more on average. The policies have to meet federal minimum requirements and offer such essential health benefits as emergency services, maternity care and substance abuse services as well as preventive and wellness care.

No longer can insurers deny coverage due to pre-existing conditions, charge women more than men, or charge exorbitant rates to older people.

"The difference this year is that there are only three factors in rating products to determine premiums: geographic location, age and tobacco use," Borman said.

Blue Cross also predicts that many people in poor health could buy coverage, driving up health care costs systemwide.

Maybe so. But people will at least have meaningful coverage that they can afford. Further, as more and more people are covered, cost shifting will decrease and the true cost of services will be determined. This is the essential first step in cost containment.

In short, the future is brighter for millions of our people, more than a million of them in North Carolina.

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Email this article

State health plan slowly beginning to kick into gear

Slowly but surely, the process of providing affordable health insurance for more than 1.5 million North Carolinians is moving along.